Individual
DR. ANDREI PETROVICH BOURDEINYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3155 ROSWELL RD NE, SUITE 140, ATLANTA, GA 30305-1821
(404) 231-1000
(404) 231-5546
Mailing address
1625 ROSWELL RD, APT.138, MARIETTA, GA 30062-3682
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR006547
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11303651
CAQH
—
01
—
649113
UNITED HEALTH CARE INS.CO
—
01
—
7467540
AETNA INSURANCE COMPANY
GA
Enumeration date
10/28/2006
Last updated
07/08/2007
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